Anterior segment optical coherence tomography (AS -OCT) as a useful tool to identify retained lens fragments in the anterior chamber

Correspondence to Haseeb Akram; haseeb.akram5@gmail.com Description We report a case of pseudophakic bullous keratopathy (PBK) in which clinical examination failed to identify a retained lens fragment (RLF) which was subsequently diagnosed using anterior segment optical coherence tomography (AS-OCT) A 79-year-old man underwent routine phacoemulsification in the right eye with Infiniti Vision System (Alcon, Fort Worth, USA) under topical anaesthesia. Other methods, such as endoscopy have also been used.3 However, AS-OCT allows fine details to be observed that may be obscured by corneal oedema and has also been used to detect postoperative Descemet’s detachment.4 AS-OCT is a versatile, simple, effective and quick imaging technique with a plethora of applications.5 In anyone presenting with corneal oedema after cataract surgery, high suspicion for RLF is warranted, especially when the eye is hypertensive and/or there is coexistent CMO. Learning points Retained lens fragment (RLF) after routine cataract surgery is an uncommon but unfortunate complication and should be suspected in any patient with significant corneal oedema with no history of endothelial disease, especially when the eye is hypertensive.